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Related Experiment Videos

Measuring vitamin D levels: surrogates are insufficient.

A H Heald1, S G Anderson, J J Scargill

  • 1The School of Medicine and Manchester Academic Health Sciences Centre, University of Manchester, Manchester, UK; Department of Medicine, Leighton Hospital, Crewe, UK.

International Journal of Clinical Practice
|November 1, 2014
PubMed
Summary

Vitamin D screening is increasing due to health concerns. This study found that standard bone profile tests, including parathyroid hormone (PTH), are insufficient for accurately detecting vitamin D deficiency.

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Area of Science:

  • Clinical Biochemistry
  • Endocrinology
  • Nutritional Science

Background:

  • Growing evidence links low vitamin D levels to adverse health outcomes.
  • Increased demand for vitamin D screening necessitates efficient diagnostic methods.

Purpose of the Study:

  • To evaluate the adequacy of parathyroid hormone (PTH) and bone profile markers in identifying vitamin D insufficiency or deficiency.
  • To determine if direct measurement of 25-hydroxyvitamin D (25-OH vitamin D) is necessary.

Main Methods:

  • Analysis of 1560 serum specimens for 25-OH vitamin D, calcium, phosphate, alkaline phosphatase (ALP), creatinine, and PTH.
  • Specimens were collected from November 2010 to November 2012.

Main Results:

  • The prevalence of vitamin D insufficiency or deficiency (25-OH vitamin D < 50 nmol/l) was 62.9%, with higher rates in males.
  • While low vitamin D correlated with lower phosphate levels, a significant proportion of deficient patients had normal PTH, calcium, phosphate, and ALP levels.
  • Even with severe deficiency (25-OH vitamin D < 10 nmol/l), many patients exhibited normal PTH and bone profile markers.

Conclusions:

  • No surrogate marker, including PTH and bone profile tests, is sufficient for screening vitamin D deficiency.
  • Direct measurement of 25-OH vitamin D is essential for accurate diagnosis despite associated costs.